Breast Revision, Malposition and Double Fold Reconstruction
The patient presents with severe breast deformity with a double inframammary fold due to inadequate release of the parasternal attachments of the pectoralis major muscle as well as bottoming out of her bilateral breast. Her reconstruction required bilateral open periprosthetic capsulectomy, circumferential open capsulotomy, removal and replacement with high profile saline implants and release of the upper pole of her breast pockets. The inferior capsular sling was absolutely essential in bringing the nipple areolar complexes more to the midline and recentralizing it as well as to reduce the bottoming out and elevating the inframammary fold. The secondary fold was released superiorly by releasing the parasternal pectoralis muscle attachment and a radial striated open superficial capsulotomy internally.
Her postop results are at six weeks. The only incision is to the inframammary of which she has, I believe, an excellent result with repositioning of the nipple areolar complexes centrally by simple internal inferior capsulorraphy and inferior capsular sling. This patient presented with multiple deformities which included the double fold, capsular contracture and lateral position of the implant and bottoming out, all which were reconstructed through solely and inframammary approach.